title: Control of thumb force using surface functional electrical stimulation and muscle load sharing.
abstract: BACKGROUND
  Stroke survivors often have difficulties in manipulating objects with their affected hand. Thumb control plays an important role in object manipulation. Surface functional electrical stimulation (FES) can assist movement. We aim to control the 2D thumb force by predicting the sum of individual muscle forces, described by a sigmoidal muscle recruitment curve and a single force direction.
  
  
  METHODS
  Five able bodied subjects and five stroke subjects were strapped in a custom built setup. The forces perpendicular to the thumb in response to FES applied to three thumb muscles were measured. We evaluated the feasibility of using recruitment curve based force vector maps in predicting output forces. In addition, we developed a closed loop force controller. Load sharing between the three muscles was used to solve the redundancy problem having three actuators to control forces in two dimensions. The thumb force was controlled towards target forces of 0.5 N and 1.0 N in multiple directions within the individual's thumb work space. Hereby, the possibilities to use these force vector maps and the load sharing approach in feed forward and feedback force control were explored.
  
  
  RESULTS
  The force vector prediction of the obtained model had small RMS errors with respect to the actual measured force vectors (0.22 ± 0.17 N for the healthy subjects; 0.17 ± 0.13 N for the stroke subjects). The stroke subjects showed a limited work range due to limited force production of the individual muscles. Performance of feed forward control without feedback, was better in healthy subjects than in stroke subjects. However, when feedback control was added performances were similar between the two groups. Feedback force control lead, especially for the stroke subjects, to a reduction in stationary errors, which improved performance.
  
  
  CONCLUSIONS
  Thumb muscle responses to FES can be described by a single force direction and a sigmoidal recruitment curve. Force in desired direction can be generated through load sharing among redundant muscles. The force vector maps are subject specific and also suitable in feedforward and feedback control taking the individual's available workspace into account. With feedback, more accurate control of muscle force can be achieved.
authors.affiliation: Laboratory of Biomechanical Engineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands. h.vanderkooij@utwente.nl.
authors.forename: Ard J
authors.initials: AJ
authors.lastname: Westerveld
authors.forename: Alfred C
authors.initials: AC
authors.lastname: Schouten
authors.forename: Peter H
authors.initials: PH
authors.lastname: Veltink
authors.forename: Herman
authors.initials: H
authors.lastname: van der Kooij
mesh_terms: D000328:Adult; D000368:Aged; D004558:Electric Stimulation; D005246:Feedback; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013933:Thumb / Q000502:physiology*